Serum transaminase levels and dengue shock syndrome in children
Abstract
Background Clinical and biochemical impacts on liver
dysfunction, as manifested by an increase in serum transaminase
levels, are common in dengue infection. Howevei; an association of
elevated serum transaminase and dengue shock syndrome (DSS)
has n ot been well-established.
Objective To assess for an association between serum transaminase
levels and the presence of DSS in children.
Methods A nested, case control study was conducted on children
aged l month to 12 years admitted to Sanglah Hospital who
were diagnosed with dengue infection. Baseline characteristics
and serum transaminase levels were recorded. Patients who were
included in the study were observed for the presence of DSS.
Those who had DSS were selected as cases, and those who did not
develop DSS were selected as controls. Data was analyzed using
bivariate and multivariate methods with 95% confidence intervals
and P value <0.05 was considered as statistically significant.
Results Ninety-four children were involeved, 4 7 children in the
case group and the other 4 7 were in the control group. Baseline
characteristics of the subjects were similar between the case and
control groups. Serum aspart ate transaminase (AST) level of
2:: 128 U/L and alanine transaminase (ALT) of 2: 40 U/L were
associated with DSS (OR 10; 95%CI 2.3 to 44.4; P=0.002) and
(OR 7 .3; 95%CI 1.6 to 32.9; P= 0.009), respectively.
Conclusion Elevated AST and ALT levels were associated
with an increased risk of DSS in children with dengue infection.
References
WHO. Dengue guidelines for diagnosis, treatment, prevention and control. 2009. p.3-16.
Chacko B, Subramaniam, G. Clinical, laboratory and radiological parameters in children with dengue fever and predictive factors for dengue shock syndrome. J Trap Pediatr. 2008;54:137-40.
WHO. Dengue haemorrhagic fever: diagnosis, tretament, prevention and control. 2nd ed. 1997. p.12-23.
Petdachai W Hepatic dysfunction in children with dengue shock syndrome. Dengue Bull. 2005;29:112-9.
Sutriani DM, Arhana BNP, Aryasa NIK. Relationship between serum transaminase and plasma protein levels and shock in dengue demorragic fever. Proceedings of the PIT IKA III IDAI; 2007 May 6-9; Yogaykarta: Buku Naskah Lengkap;c2007.p.200-5.
de Souza LJ, Nogueira RM, Soares LC, Ribas BF, Alves FP, Vieira FR, et al. The impact of dengue on liver function as evaluated by aminotransferase level. Braz J Infect Dis. 2007;11:407-10.
Mohan B, Patwari AK, Anand VK. Hepatic dysfuntion in childhood dengue infection. J Trap Pediatr. 2000;46:40-3.
Chhina RS, Goyal O, Chhina KD, Goyal P, Kumar R, Puri S. Liver function test in patients with dengue viral infection. Dengue Bull. 2008;32:110-7.
Darajat A, Sekarwana N, Setiabudi D. Hubungan kadar aspartat aminotransferase (AST) dan alanin aminotransferase (ALT) serum dengan spektrum klinis infeksi virus dengue pada anak. Sari Pediatri. 2008;9:359-62.
Gupta V, Yadav TP, Pandey RM, Singh A, Gupta M, Kanaujiya P, et al. Risk factors of dengue shock syndrome in children. J Trap Pediatr. 2011;57:451-6.
Tantracheewathorn T, Tantracheewathom S . Risk factor of dengue shock syndrome in children. J Med Assoc Thai. 2007;90:272-7.
Itha S, Kashyap R, Krishnani N, Saraswat VA, Chaudhuri G, Aggarwal R. Profile of liver involvement in dengue virus infection. Natl MedJ India. 2005;18:127-30.
Seneviratne SL, Malavige GN, de Silva HJ. Pathogenesis of liver involvement during dengue viral infection. Trans R Soc Trap Med Hyg. 2005;100:1055-66.
Wahid SF, Sanusi S, Zawawi MM, Ali RA. A comparison of the pattern of liver involvment in dengue hemorrhagic fever with classic dengue fever. Southeast Asian] Trap Med Public Health. 2000;31:259-63.
Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou SS, Liaw YF. Liver biochemical test and dengue fever. Am J Trap Med Hyg. 1992;47:265-70.
Nguyen TL, Nguyen TH, Tieu NT. The impact of dengue haemorrhagic fever on liver function. Res Viral. 1997;148:273-7.
Ageep AK, Elgasim AS. A correlation study between clinical manifestation of dengue fever and the degree of liver injury. J Microbial Antimicrob. 2012;4:45-8.
Kabir A, Abdullah M, Sadeka MM, Ahmed H, Kahhar MA. The impact of dengue on liver function as evaluated by aminotransferase level. J Med. 2008;9:60-8.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2016-09-09
Published 2014-06-30